Using Open-Source Large Language Models to Identify Access to Germline Genetic Testing in Veterans With Breast Cancer From Unstructured Text.

Purpose: The ability of large language models (LLMs) to identify access to germline genetic testing from unstructured text remains unknown. The Department of Veterans Affairs (VA) assessed access in Veterans with breast cancer by implementing and evaluating the performance of open-source, locally deployable LLMs (Llama 3 70B, Llama 3 8B, and Llama 2 70B) in identifying access from clinical/consult notes.

Methods: We identified a cohort of 1,201 Veterans diagnosed with breast cancer between January 1, 2021, and December 31, 2022, who received cancer care within the nationwide VA system and had clinical and/or consult notes available.

Mainstreaming improved adoption of germline testing for Veterans Affairs patients with metastatic prostate cancer without exacerbating disparities.

Purpose: To improve germline testing adoption for Veterans Affairs patients with metastatic prostate cancer (mPrCA), new delivery models were introduced to complement genetic consultation (traditional model), including mainstreaming where oncologists perform pre/posttest activities and a hybrid model where oncologists perform informed consent and then refer to genetics. We assessed germline testing adoption by delivery model.

Methods: We conducted a nationwide cohort study of mPrCA patients ascertained from May 3, 2021, to November 2, 2022, with follow-up through May 3, 2023.

The need to consider the service life of all components of a modern MSW landfill liner system.

The long-term performance of a geosynthetic clay liner (GCL) above a drainage layer and a geocomposite drain (GCD) are investigated. Full-scale tests are used to: (i) assess the integrity of GCL and GCD in a double composite liner below a defect in the primary geomembrane with ageing, and (ii) establish the head at which there was internal erosion in GCL without a carrier geotextile (GTX) such that the bentonite is in direct contact with the underlying gravel drainage. Six years after contact with simulated landfill leachate at 85 °C through an intentional defect on the geomembrane, the GCL resting on the GCD had failed due to degradation of the GTX between the bentonite and the core of the GCD and subsequent erosion of the bentonite into the core structure of the GCD was observed.

Surveillance Imaging with PET/CT and CT and/or MRI for Head and Neck Cancer and Mortality: A Population-based Study.

Background To the knowledge of the authors, no strong evidence supports surveillance imaging in patients with head and neck cancer (HNC). Purpose To investigate the association between surveillance imaging and mortality using a population-based study design with statewide cancer registry data, all-payer claims data, and health care facility data. Materials and Methods The retrospective population-based study identified patients with HNC diagnosed between January 2012 and December 2017.

Comorbidity and Cancer Disease Rates among Those at High-Risk for Alzheimer's Disease: A Population Database Analysis.

(1) Importance: Alzheimer's disease (AD) is complex and only partially understood. Analyzing the relationship between other more treatable or preventable diseases and AD may help in the prevention and the eventual development of treatments for AD. Risk estimation in a high-risk population, rather than a population already affected with AD, may reduce some bias in risk estimates.

Sexual dysfunction among gynecologic cancer survivors in a population-based cohort study.

Treatment for gynecologic cancer is associated with sexual dysfunction, which may present during and/or after treatment. The aim of this study was to investigate the risk of sexual dysfunction among gynecologic cancer survivors compared to cancer-free women in a population-based cohort study. We identified a cohort of 4863 endometrial, ovarian, and cervical cancer survivors diagnosed between 1997 and 2012 in the Utah Cancer Registry.

Effects of perfluoroalkyl substances (PFAS) on antioxidant depletion from a high-density polyethylene geomembrane.

To safely contain Per-and Polyfluoroalkyl substances (PFAS) in municipal solid waste landfills and contaminated soil monofills, it is necessary to understand how these substances interact with components of engineered systems designed to contain them. This paper examines the interaction between one of the most critical components of the system: a high-density polyethylene (HDPE) geomembrane. The same geomembrane is immersed in PFAS solution and synthetic municipal solid waste leachate containing PFAS for 2.

A likely HOXC4 predisposition variant for Chiari malformations.

Objective: Inherited variants predisposing patients to type 1 or 1.5 Chiari malformation (CM) have been hypothesized but have proven difficult to confirm. The authors used a unique high-risk pedigree population resource and approach to identify rare candidate variants that likely predispose individuals to CM and protein structure prediction tools to identify pathogenicity mechanisms.

Mental health disorders are more common in patients with Hodgkin lymphoma and may negatively impact overall survival.

Background: Long-term mental health outcomes were characterized in patients who were diagnosed with Hodgkin lymphoma (HL), and risk factors for the development of mental health disorders were identified.

Methods: Patients who were diagnosed with HL between 1997 and 2014 were identified in the Utah Cancer Registry. Each patient was matched with up to five individuals from a general population cohort identified within the Utah Population Database, a unique source of linked records that includes patient and demographic data.

Mental health disorders among ovarian cancer survivors in a population-based cohort.

Background: Ovarian cancer is the fifth most common female cancer in the United States. There have been very few studies investigating mental health diagnoses among ovarian cancer survivors with long-term follow up. The aim of this study is to examine the incidence of mental illness among ovarian cancer survivors compared to a general population cohort.

Cardiovascular disease risk in long-term breast cancer survivors: A population-based cohort study.

Background: Breast cancer survival is increasing, making late effects such as cardiovascular disease (CVD) more relevant. The purpose of this study was to evaluate incident CVD following breast cancer diagnosis among long-term survivors and to investigate possible risk factors for CVD.

Methods: A population-based cohort of 6641 breast cancer survivors diagnosed between 1997 and 2009 who survived at least 10 years was identified within the Utah Cancer Registry.

Age-Related Disease Risks in Younger versus Older B-Cell Non-Hodgkin's Lymphoma Survivors.

Background: Younger cancer survivors may develop age-related diseases due to the cancer treatment that they undergo. The aim of this population-based study is to estimate incidence of age-related diseases besides cardiovascular disease among younger versus older B-cell non-Hodgkin's lymphoma (B-NHL) survivors compared with their respective general population cohorts.

Methods: Survivors of B-NHL were diagnosed between 1997 and 2015 from the Utah Cancer Registry.

Cardiovascular disease risks in younger versus older adult B-cell non-Hodgkin's lymphoma survivors.

Introduction: Young cancer survivors may be at increased risk of early-onset chronic health conditions. The aim of this population-based study is to estimate cardiovascular disease (CVD) risk among younger versus older B-cell non-Hodgkin's lymphoma (B-NHL) survivors compared with their respective general population cohorts.

Methods: B-NHL survivors diagnosed from 1997 to 2015 in the Utah Cancer Registry were matched with up to five cancer-free individuals on birth year, sex, and birth state, using the statewide Utah Population Database.

Disparities in Cardiovascular Disease Risk Among Hispanic Breast Cancer Survivors in a Population-Based Cohort.

Background: Breast cancer is the leading cause of cancer death among Hispanic women. The aim of our study was to estimate cardiovascular disease (CVD) risk among Hispanic and non-Hispanic White (NHW) breast cancer survivors compared with their respective general population cohorts.

Methods: Cohorts of 17 469 breast cancer survivors (1774 Hispanic and 15 695 NHW) in the Utah Cancer Registry diagnosed between 1997 and 2016, and 65 866 women (6209 Hispanic and 59 657 NHW) from the general population in the Utah Population Database were identified.

A role for the MEGF6 gene in predisposition to osteoporosis.

Osteoporosis is a common skeletal disorder characterized by deterioration of bone tissue. The set of genetic factors contributing to osteoporosis is not completely specified. High-risk osteoporosis pedigrees were analyzed to identify genes that may confer susceptibility to disease.

PFOA and PFOS diffusion through LLDPE and LLDPE coextruded with EVOH at 22 °C, 35 °C, and 50 °C.

Diffusion of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) through 0.1 mm and 0.75 mm LLDPE and 0.

Control and estimation of maximum gas pressure below landfill cover with horizontal gas wells: Analytical study.

Horizontal spacing of horizontal extraction gas wells can be designed to achieve a 90% pumping rate of the total generated landfill gas (LFG) from given waste properties (viz: gas permeability, landfill gas generation and non-homogeneity with depth), cover characteristics and vacuum pressure. However, cover characteristics and vacuum pressure are also important design parameters and different combinations of them result in different distributions of gas pressure in the waste, some of which would induce problematic air intrusion while others might pose threat to cover stability. This paper uses the maximum gas pressure directly below cover to distinguish these combinations, and provides the first study of the effects of the above parameters on potential outcomes.

Genome-wide analysis of high-risk primary brain cancer pedigrees identifies PDXDC1 as a candidate brain cancer predisposition gene.

Background: There is evidence for an inherited contribution to primary brain cancer. Linkage analysis of high-risk brain cancer pedigrees has identified candidate regions of interest in which brain cancer predisposition genes are likely to reside.

Methods: Genome-wide linkage analysis was performed in a unique set of 11 informative, extended, high-risk primary brain cancer pedigrees identified in a population genealogy database, which include from 2 to 6 sampled, related primary brain cancer cases.

Genitourinary disease risks among ovarian cancer survivors in a population-based cohort study.

Objective: While genitourinary complications during treatment for ovarian cancer are well-known, long-term adverse outcomes have not been well characterized. The number of ovarian cancer survivors has been increasing. The aim of this study was to investigate long-term adverse genitourinary outcomes in a population-based cohort.

Individualized prediction of late-onset dysphagia in head and neck cancer survivors.

Background: Limited data exist regarding which head and head and neck cancer (HNC) survivors will suffer from long-term dysphagia.

Methods: From a population-based cohort of 1901 Utah residents with HNC and ≥3 years follow-up, we determined hazard ratio for dysphagia, aspiration pneumonia, or gastrostomy associated with various risk factors. We tested prediction models with combinations of factors and then assessed discrimination of our final model.

Rural-urban disparities in colorectal cancer survival and risk among men in Utah: a statewide population-based study.

Rural areas of the U.S. experience disproportionate colorectal cancer (CRC) death compared to urban areas.

Risk of pelvic organ prolapse treatment based on extended family history.

Background: Family history of pelvic organ prolapse among first-degree relatives is an established risk factor for pelvic organ prolapse; however, consideration of the constellation of family history that extends to distant relationships allows for more accurate determination of risk and may improve pelvic organ prolapse risk prediction estimates.

Objective: The purpose of this study was to assess risk for pelvic organ prolapse treatment based on varying family histories of pelvic organ prolapse and included number and types of affected relatives, ages of relatives at pelvic organ prolapse treatment, and whether the family history is of maternal or paternal origin.

Study Design: This was a retrospective, population-based study that involved the Utah Population Database, which is a population resource that includes extensive genealogy information linked to medical records.

Long-term diabetes risk among endometrial cancer survivors in a population-based cohort study.

Objective: The majority of endometrial cancer patients are overweight or obese at cancer diagnosis. Obesity is a shared risk factor for both endometrial cancer and diabetes, but it is unknown whether endometrial cancer patients have increased diabetes risks. The aim of our study was to investigate diabetes risk among endometrial cancer patients.

Adverse respiratory outcomes among head and neck cancer survivors in the Utah Cancer Survivors Study.

Background: The number of head and neck cancer (HNC) survivors has been increasing because of improving survival in the United States. The aim of this study was to evaluate the incidence of respiratory disease diagnoses in HNC survivors in comparison with cancer-free individuals. A second aim was to investigate risk factors for respiratory disease among HNC survivors.